Newfoundland Premier Danny Williams speaks in St. John's on January 28, 2009.Paul Daly
A torrent of public sympathy, anger and ridicule flowed into a vacuum of official information Tuesday about the cardiac health of Danny Williams.
The Newfoundland and Labrador Premier's decision to have undisclosed heart surgery at an unnamed U.S. clinic also reignited a simmering debate about the state of Canadian health care.
His deputy premier, Kathy Dunderdale, waded into the fray with few details beyond stressing that treatment in St. John's wasn't offered.
"Having the surgery done in the province was never an option," she said.
Mr. Williams, 60, said nothing of his impending departure when he met reporters Friday after a meeting with Prime Minister Stephen Harper in St. John's.
The avid hockey and golf buff looked fit and rested at the time. He is said to have joked to friends that it will be toughest to miss his weekly chance to cut up the ice in a recreational hockey league.
Mr. Williams met over the last several weeks with local doctors before leaving town, Ms. Dunderdale said. As his government moves ahead with budget preparations, the Premier is expected to be out of commission for three to 12 weeks.
"Any heart surgery is serious," Ms. Dunderdale said. "However, his prognosis is very, very good."
An outpouring of well wishes for the Premier's speedy recovery hit the Internet and lit up open line call-in shows. In no-holds-barred Newfoundland fashion, many writers and callers expressed their support for an icon-like leader, and their distaste for what they considered media prying into medical affairs.
Others assailed Mr. Williams for creating confusion by not issuing a clear statement before heading for the border.
And there were those who boiled it down to matters of money.
"Gee, it must be nice to be able to afford to bypass Canada's crappy health-care system and its dangerously long waiting lists for surgery," said one person in a post to The Globe and Mail's website.
"Some people are more special than others, I guess."
Mr. Williams made news in the United States too.
"This is what happens when you have a health-care system whose goal is saving money, not lives," said a blogger with the Charleston Daily News.
Ms. Dunderdale declined to say what kind of procedure Mr. Williams needs, where and when it will take place or whether it was available elsewhere in the country.
She was asked what kind of message his decision might send to people who can't afford care in the United States.
"Ultimately we have to be the gatekeepers of our own health and he has taken medical advice from a number of different sources," Ms. Dunderdale said. "He is doing what's best for him."
Mr. Williams, a self-confessed workaholic father of four grown children and a grandfather of four, also wanted "to do everything he could to have the best outcome and be back on his feet and back doing his job as quickly as possible," she said.
Ms. Dunderdale wasn't sure if Mr. Williams would cover his own medical costs.
"I would expect that he is eligible for all that the rest of us would be in terms of our own private insurance or government insurance and I'm sure if there's anything over and above that the premier will certainly take care of it himself."
Ms. Dunderdale will serve as the province's acting premier while Mr. Williams recovers.
Mr. Williams, an independently wealthy former lawyer and businessman, donates his Premier's salary to his own foundation that funds local charities.
He is willing to explain his decision once he is well enough to do so, Ms. Dunderdale said.
Public versus private health care is a hot potato that has landed in many political laps. Former Liberal prime minister Paul Martin took flak in 2004 for the fact that his long-time physician ran a network of private clinics. Martin denied ever using private health care.
Former Tory prime minister Joe Clark was criticized by the former Canadian Alliance party after he said he had surgery at a private clinic in the late 1980s.
And former Quebec premier Robert Bourassa had skin cancer treatments in the early 1990s as part of a clinical trial at the U.S. National Cancer Institute in Bethesda, Md. An institute spokesman at the time said the U.S. government covered the bill.
The head of Eastern Health, the province's largest health authority, said Mr. Williams headed south on the advice of local physicians.
"He trusted us," Vickie Kaminski said. "And he trusted their recommendations - which were referrals out of the province."
Ms. Kaminski stressed that Mr. Williams had "some very high risk surgery done here in the past on his back."
Asked what sorts of cardiac procedures are not available in the province, she said it's more about appropriate treatment and cutting-edge technology.
"There are some very new techniques that come on the market that will be piloted and tested, and there will be a small locus of people across North America doing it just because there aren't enough patients who qualify."
Ms. Kaminski would not talk in any detail about the premier's condition, citing privacy issues.
Ms. Kaminski said there are 55 cardiac patients on wait lists for treatment in the province but "all of them are getting their surgery within the wait times that are being recommended."
Those are generally between four and six weeks, though the most urgent cases are handled right away, she said.
In an interview last year, Mr. Williams spoke candidly about the stresses and frustrations of the job he has held since 2003.
The Premier openly mused about his occupational choice. Still, he has said repeatedly in recent months that he has every intention of running in the next provincial election slated for 2011.
Michael McBane, national co-ordinator of the non-profit Canadian Health Coalition, said a small fraction of wealthy Canadians have always headed south for treatment for many reasons.
But state-side care is hardly a trend and Mr. Williams is "a strong defender of the public health care system," he said.
Canadians can often get better care here than the United States, Mr. McBane added.
"Our system is tremendous and we shouldn't be misrepresenting these kinds of stories to come to false conclusions about the quality of the public health care system."